Background. Early prognosis, adequate goal setting, and referral are important for stroke management. Objective. To investigate if independent gait 6 months poststroke can be accurately predicted within the first 72 hours poststroke, based on simple clinical bedside tests. Reassessment on days 5 and 9 was used to check whether accuracy changed over time. Methods. In 154 first-ever ischemic stroke patients unable to walk independently, 19 demographic and clinical variables were assessed within 72 hours and again on days 5 and 9 poststroke. Multivariable logistic modeling was applied to identify early prognostic factors for regaining independent gait, defined as ≥4 points on the Functional Ambulation Categories. Results. Multivariable modeling showed that patients with an independent sitting balance (Trunk Control Test-sitting; 30 seconds) and strength of the hemiparetic leg (Motricity Index leg; eg, visible contraction for all 3 items, or movement against resistance but weaker for 1 item) on day 2 poststroke had a 98% probability of achieving independent gait at 6 months. Absence of these features in the first 72 hours was associated with a probability of 27%, declining to 10% by day 9. Conclusions. Accurate prediction of independent gait performance can be made soon after stroke, using 2 simple bedside tests: "sitting balance" and "strength of the hemiparetic leg." This knowledge is useful for making early clinical decisions regarding treatment goals and discharge planning at hospital stroke units. © The Author(s) 2011.
Veerbeek, J. M., van Wegen, E. E. H., Harmeling-van der Wel, B. C., & Kwakkel, G. (2011). Is Accurate Prediction of Gait in Nonambulatory Stroke Patients Possible Within 72 Hours Poststroke? The EPOS Study. Neurorehabilitation and Neural Repair, 25(3), 268-274. https://doi.org/10.1177/1545968310384271